On September 10th the California Supreme Court let stand a California Appeals Court decision that the California mental health parity law requires coverage of treatment that may have no equivalent in other medical specialties. Specifically, the Appeals Court held that Blue Shield of California must cover residential treatment for eating disorders. The Court noted that residential treatment was among the …
Early Lithium Treatment for Bipolar – Better Outcomes?
Does early lithium treatment for bipolar lead to better outcomes? This is the question that researchers sought to answer by looking at a Danish database of health information. The Danish registry is a set of nearly complete health information on the population of Denmark (hence, studies using this database are more representative of the general population than studies from many …
Weight Gain with Atypical Antipsychotics – A Review of Strategies
Many antipsychotics, especially some atypical or second generation antipsychotics, like olanzapine (Zyprexa) or quetiapine (Seroquel), cause significant weight gain, as well as insulin resistance (diabetes) and elevated lipids. What to do if the medication is helping (much more than alternatives) but the patient is developing these serious adverse effects? Two recent articles review the literature on strategies for managing these …
Low Frequency Magnetic Stimulation is Rapid Antidepressant
There is a lot of interest in an article that just appeared in Biological Psychiatry about a new magnetic stimulation technique that may be associated with rapid antidepressant effects in both unipolar and bipolar depression. Researchers at McLean Hospital were studying Low Frequency Magnetic Stimulation as a way of imaging the brains of bipolar patients and discovered that many of …
New Drug with New Mechanism for Insomnia – Suvorexant
Belsomra (suvorexant) was approved earlier this week by the FDA for use as needed to treat difficulty in falling and staying asleep. The drug blocks receptors for orexin – also known as hypocretin – the master hypothalamic regulator of the sleep-wake cycle. There are, in fact, two forms of orexin, A and B; hence it is a dual orexin …
Depression Costs US 200 Billion Dollars Per Year
A meta-analysis of more than 60 clinical studies covering almost 60,000 adult patients estimates that the total cost in the United States of the treatment of patients with depression is in the range of $188 billion to $200 billion. Roughly a third of all costs ($64 billion) are related to people with treatment-resistant depression, who represent only a fraction of all cases. The article, “A Review of the Clinical, Economic, …
Lithium Treats Bipolar Depression
In a special symposium on bipolar disorder at the 2014 meeting of the American Psychiatric Association, researcher Mike Bauer reviewed a new meta-analysis that showed lithium not only has significant effects in preventing manias, but also depressions. Mike Bauer is currently the Director and Executive Chair of the Department of Psychiatry and Psychotherapy, and the Physician-in-Chief, at the Psychiatric Hospital …
Antidepressants are not Effective for Bipolar Depression
Mark Frye, Chairman of the Department of Psychiatry at the Mayo Clinic, gave a lecture on antidepressants in bipolar illness at the 2014 meeting of the American Psychiatric Association. The newest data from meta-analyses indicate that traditional antidepressants that are effective in unipolar depression are not effective in bipolar depression. Some patient groups, especially those with very early onset depression …
Vortioxetine a New Antidepressant
Vortioxetine (Brintellix) is a new antidepressant that has a range of effects on serotonin receptors, making it different from selective serotonin reuptake inhibitors (SSRIs), the most common type of antidepressants, which work only on the serotonin transporter. Researcher Johan Areberg et al. reported at the 2014 meeting of the American Psychiatric Association that the drug is an antagonist at receptors …
Lithium versus Quetiapine for Bipolar Disorder
In a recent study comparing the efficacy of lithium and the second-generation antipsychotic quetiapine, the drugs had remarkably similar results. Researcher Andrew Nierenberg et al. presented the results at the 2014 meeting of the American Society of Clinical Psychopharmacology. By the end of the 6-month study period, most patients had improved substantially, but only about a quarter of each group became …